Nancarrow Susan, Moran Anna, Freeman Jenny, Enderby Pamela, Dixon Simon, Parker Stuart, Bradburn Mike
Faculty of Health and Wellbeing, Centre for Health and Social Care Research, Sheffield Hallam University, 33 Collegiate Crescent, Sheffield S102BP, UK.
Qual Prim Care. 2009;17(5):323-33.
To generate a picture of the range, configuration and staffing of community and intermediate care services in the United Kingdom (UK) and to ascertain whether any relationships exist between service configuration and staffing models.
A service audit tool was sent to members of the Community Therapist's Network (CTN) and to chief executives of primary care and National Health Service trusts in the UK. Data were collected from the CTN and chief executives of primary care trusts (PCTs) and NHS trusts between late 2005 and early 2006.
The overall response rate to the two audits was 37% (n = 243), with 77% of these responses (n = 186) useable. Services varied greatly in terms of their organisation and staffing configurations. Skill mix varied according to the location of service delivery, with home-based services utilising more therapy and support staff than inpatient services. Two clusters of service emerged, based on the number of referrals per year, support staff in the team and the level of care provided by the service.
There are no clear patterns to the structure and organisation of community and intermediate care services in relation to their purpose, and it remains unclear how different staffing configurations impact on service costs and patient outcomes. The amount of variation observed indicates that there is likely to be considerable variability in service costs and outcomes for the teams. Further evidence is required to determine the impact of different staffing models, and to identify approaches that optimise both effectiveness and efficiency.
描绘英国社区及中级护理服务的范围、配置和人员配备情况，并确定服务配置与人员配备模式之间是否存在任何关系。
向社区治疗师网络（CTN）成员以及英国初级保健和国民健康服务信托基金的首席执行官发送了一份服务审计工具。在2005年末至2006年初期间，从CTN以及初级保健信托基金（PCT）和国民健康服务信托基金的首席执行官处收集了数据。
两项审计的总体回复率为37%（n = 243），其中77%的回复（n = 186）可用。服务在组织和人员配备配置方面差异很大。技能组合根据服务提供地点的不同而有所变化，居家服务比住院服务使用更多的治疗和支持人员。根据每年的转诊数量、团队中的支持人员以及服务提供的护理水平，出现了两类服务。
社区和中级护理服务的结构与组织与其目的之间没有明确的模式，不同的人员配备配置如何影响服务成本和患者结局仍不清楚。观察到的差异程度表明，各团队的服务成本和结局可能存在很大差异。需要进一步的证据来确定不同人员配备模式的影响，并确定优化有效性和效率的方法。
